Somehow during his tenure as SOUTHCOM commander, current EUCOM commander and Supreme Allied Commander Europe Admiral James G. Stavridis, found time to pen a 292 page book on the United States’ relationship with Central America (except Mexico), South America, and the Caribbean. The book was just published by NDU press and is available for free on their website.

Stavridis’ book, Partnership For The Americas, is not your typical command memoir; rather it reads more like a manifesto on the potential of soft power in US-South relations. His main takeaway point: “We are all in this together”.

The book covers a range of topics, from counter-narcotics operations to innovation in the Department of Defense, but of particular interest to me is the Admiral’s chapter on health engagement. Specifically, the role he argues medical diplomacy can play in a combatant command:

“It may seem at first incongruous for a combatant command, even one which strives to be as interagency-oriented and forward-leaning as U.S. Southern Command, to be engaged in efforts to improve public health. And perhaps it is, particularly if that is how our engagement efforts are expressed or viewed. If, however, we restructure our strategic approach and message to convey that we subscribe to the understanding that “public health” plays a vitally important role in maintaining long-term stability, then we can restate our strategic objectives more along the lines of removing and/or reducing health issues as a potential factor to increased likelihood of conflict. Thus, our continuing commitment to engaging in what some have termed “medical diplomacy” becomes inherently synchronized with our previously stated strategic goals to promote security, enhance stability, and allow for economic prosperity.” (Stavridis 2010, 140)

This is not something you would expect to read from a man occupying the same office as Eisenhower and Ridgway. However, Stavridis is absolutely correct. While the core competency of the American military will always be combat operations, there are a growing number areas where United States interests and goodwill can best be secured through soft power, including health diplomacy. In an ideal world these tasks would be the responsibility of USAID and the Department of State, but, to adapt a phrase from former Defense Secretary Donald Rumsfeld: you advance US interests with the agencies you have, not the agencies you want. And if you can do so with hospital ships instead of gunboats, all the better.

Haven’t read the book, but will (pls say it is iPad available…). Just a thought — make the last 2 (or 4) JHSVs mini-hospital ships. Prepo in SOUTHCOM, PACCOM (Far East), and other — on constant Goodwill/Global Force For Good mission. They’ll have to speed to get rapidly in their AOR where they would be more useful. Would need to change the Medical community a bit to provide personnel – (or throw some Army/AF/USCG med folks on and make it…Joint?) Joint High Speed Vessel – Hospital? (JHSV-H…This idea might already be in ADM Stav’s book)

http://www.stratfor.com nhughes

I second Jay’s motion. I’m less concerned with the platform than with expanding the capacity into more diverse offerings. JHSV will eventually be a great option. In addition, the utility of the hospital facilities in LPDs and LSDs in the African and South Partnership Station deployments (though I admit my knowledge about these deployments is limited) strikes me as a pretty viable proof of concept for the integration of the health diplomacy with other elements of soft power — and efforts to incrementally improve maritime security to boot.

The USNS Mercy and Comfort are great assets, but there is a lot of room for further expansion under the APS/SPS concept, something akin to the influence squadrons first proposed in Proceedings (I believe) and other innovative efforts on the lower end of the spectrum.

Byron

And with a shrinking Navy and a shrinking budget, who will pay the operating expenses for the “Health Diplomacy”? The Navy? Bad idea, how about we get the State Dept to pony the money up.

Don’t get me wrong. I’ve got nothing against the Navy showing the gentle hand of help when needed…but it’s the strong hand of force that is the Navy’s raison d’etre. Put simply, the Navy is NOT the Salvation Army. This is a diplomacy function, pure and simple; let the budget come from State.

sid

If there was ever a need for a “mothership/module” concept it would be for a next gen “AH” concept.

The idea of a purpose built AH is an anchronism.

Make the elements both modular and scalable to fit aboard ships that can accept a standrd TEU…JHSV, or a chartered tramp…As well as make some of the elements (triage, CBD/Radiological, etc.) air transportable as well.

Byron — as you are aware, we do LOTS of “should be State” type stuff — to include training of other forces, building lasting relationships, etc. — that aren’t emergency humanitarian response or warfighting. This would fit nicely (I suspect) in the Defense Security Cooperation Agency bailiwick. I had the pleasure to work for for the Office of Defense Cooperation (ODC) in our London Embassy. ODCs work for the DSCA, they are in most of our Embassies, with very small staffs, (and work somewhat closely with the Defense Attache’s office) – in different areas, depending upon the host nation desires/needs. Good relationship building & info flow for very little money. Worth every penny.

leesea

folks, the medical modules already exist and have so for years in the form of the Expeditionary Medical Facilities of the Navy Medical Logisics unit formerly Fleet Hospitals which were prepositioned from the late 1980s onward. Mostly containers but significant support vehicles used by Seabees to transport, set up and operate ashore.

The platform is important because the big T-AH19 class cannot get into smaller ports and likewise the JHSV/HSV do NOT have much endurance or time on-station. What is needed is a “handy sized T-AH” based on an existing design.

A key capability of any medical diplomancy ship is its ability to perform MEDCAP missions ashore and to support inland operations for long periods of time. Neither T-AH19 class nor JHSV-H can do both. Multiple boats and helos are part of that.

We’ve published it in .mobi, .pdf, and .epub format and the book is available on the Amazon Kindle site. We’re hoping it also shows up in the Apple eBookstore later this week.

-Joey Seich, Internet Publications Editor, NDU Press

Raymond Clark

Although it may seem reasonable to say “let State pony up for this”, in reality State is chronically short of funds to do it’s mission, and therefore simply isn’t capable of adding another program. In recent years, this has meant that more and more seemingly “off-mission” activities have developed to the DoD. Some decry DoDs “mission creep”, whereas others see it as a natural evolution of DoD’s broader mission of providing security for the U.S. interationally. Frankly, I don’t see the DoD pulling back from these types of missions unless there is significant restructuring of funding throughout the Executive Branch of the White House. Regardless, this is an excellent book from somebody who knows the region quite well.

Steve

As the good Admiral knows, MEDCAPS and most ship-borne medical work are not ‘public health’, which focuses on sustainable, preventive, population-based intervention. The USNS Mercy and Comfort do none of this on their missions. Their effect is transient and ‘hearts and minds’, and – unfortunately – very old-fashioned. In the Cold War era, that was okay. Not today.
Modern public health interventions leave a legacy, and an improved health return on investment. It builds partner-nation capacity, rather than displacing or devaluing the local care system. Its positive effects continue after the gringos have gone home. It empowers locals to secure their own backyard.
As Mr. Clark says above, and ADM Stavridis well knows, DoD has deep pockets (unlike Dept of State) and public health capacity building in partner nations has mutual security value. In the modern era, it is our job.